As a new session of Congress has begun, and a new Administration begins in a matter of days, it is time to expand on important oversight and consumer protection measures surrounding Medicare Advantage (MA) plans. Over the last 4 years, progress has … [Read more...] about Change in Government Should Not Lead to a Change in Scrutiny of Medicare Advantage
Weekly Alert
Know Jimmo | Medicare Home Health Coverage Available for People with Ongoing Conditions
Medicare home health coverage offers the promise of allowing eligible individuals (legally homebound and in need of skilled care), to remain at home with the care they need. According to Medicare law, regulations, and policy, home health coverage … [Read more...] about Know Jimmo | Medicare Home Health Coverage Available for People with Ongoing Conditions
Know Jimmo | Important Message about the Settlement
“The Jimmo Settlement Agreement may reflect a change in practice for those…who may have erroneously believed that the Medicare program covers nursing and therapy services under these benefits only when a beneficiary is expected to improve. The Jimmo … [Read more...] about Know Jimmo | Important Message about the Settlement
Reminder: Prescription Drug Cost Cap In Effect
The new $2,000 cap on out-of-pocket costs for prescription drugs is now in effect as of January 1. As part of the Inflation Reduction Act, people with Medicare Part D will pay no more than $2,000 for all their covered prescription drugs for all of … [Read more...] about Reminder: Prescription Drug Cost Cap In Effect
New Resources on Observation Status Appeals!
New year, new right to appeal. In 2025, as a result of the Center’s class action lawsuit, certain Medicare beneficiaries will have a new right to appeal their placement on “observation status” in hospitals. Information about these appeals is now … [Read more...] about New Resources on Observation Status Appeals!
Effective Enforcement: Two New Jersey Nursing Home Operators Suspended
Acting New Jersey State Comptroller Kevin Walsh continues to present a model for effective enforcement of nursing home standards of care – barring the poorest quality operators and their multiple related parties and affiliates from receiving any … [Read more...] about Effective Enforcement: Two New Jersey Nursing Home Operators Suspended
Protecting Medicare Beneficiaries: Fraud, Flex Card Risks, and Recent Scams
The Center for Medicare Advocacy recently highlighted issues beneficiaries experience after fraud, consequences that come with Medicare Advantage flex cards and recent Social Security scams for the SHIP & SMP publication "Medicare Messenger." … [Read more...] about Protecting Medicare Beneficiaries: Fraud, Flex Card Risks, and Recent Scams
Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
“Maintenance Therapy – Therapy services in connection with a maintenance program are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. … [Read more...] about Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
A huge victory for Veterans living with ALS!
From our friends at I Am ALS: The Elizabeth Dole bill has now been passed by BOTH chambers of Congress! Now all that's left is for President Biden to sign it into law. The passage of this bill makes numerous improvements to the Veterans Affairs … [Read more...] about A huge victory for Veterans living with ALS!
Elder Justice “No Harm” Newsletter Volume 6, Issue 2 Now Available
In the Elder Justice Newsletter, we highlight citations, including deficiencies related to abuse, neglect, and substandard care, that have been identified as not causing any resident harm. The goal of this brief newsletter is to shed light on … [Read more...] about Elder Justice “No Harm” Newsletter Volume 6, Issue 2 Now Available